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Ngatuvai M, Pasarin A, Gabra A, Pidhorecky I. A Rare Case of Triple-Positive Breast Cancer With Eventual Triple-Negative Small Bowel Metastasis. Cureus 2024; 16:e74308. [PMID: 39717332 PMCID: PMC11665740 DOI: 10.7759/cureus.74308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 11/23/2024] [Indexed: 12/25/2024] Open
Abstract
Invasive lobular breast cancer (ILBC) is a common cause of breast cancer. Prognosis is dependent on many factors such as metastasis location and hormone receptor positivity. A 59-year-old postmenopausal African-American female who was referred to our clinic in May of 2022 presented with a suspicious small bowel lesion seen on surveillance imaging. The patient was diagnosed 15 years prior, with hormone receptor triple positive ILBC of the left breast, T1N2M0. In March of 2021, the patient was admitted to the hospital for rectal bleeding and was also found to have an elevated carcinoembryonic antigen (CEA) level. Computed tomography of the abdomen and pelvis was performed, which revealed a 4 cm segment of proximal ileum that was indeterminate for inflammation, neoplasm, or focal ischemia. The patient ultimately agreed to proceed with a diagnostic laparoscopy to further identify this area and underwent a small bowel resection. The final pathology of this specimen revealed a poorly differentiated, diffuse-type carcinoma with a focal mucinous matrix. The tumor involved the submucosa, serosa, and pericolonic adipose tissue. The morphology was consistent with metastatic carcinoma originating from ILBC. The hormone receptors for this specimen revealed estrogen-receptor (ER) negative, progesterone-receptor (PR) negative, and human epidermal growth factor receptor-2 (HER-2) negative. Lobular breast cancer metastasis to the small bowel as well as triple positive to triple negative conversion is exceedingly rare. The recurrence and metastasis of breast cancer are considerably high and the survival rate for these individuals has shown little improvement throughout the last decade. Defining relevant prognostic markers is crucial for improved management with known metastasis and triple negative receptors.
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Affiliation(s)
- Micah Ngatuvai
- Orthopedics, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
- Orthopedics, Texas Tech University Health Sciences Center, El Paso, El Paso, USA
- Orthopedics, William Beaumont Army Medical Center, El Paso, USA
| | - Anthony Pasarin
- Surgical Oncology, HCA Florida Westside Hospital, Plantation, USA
| | - Abanoub Gabra
- Pathology, HCA Florida Westside Hospital, Plantation, USA
| | - Ihor Pidhorecky
- Surgical Oncology, HCA Florida Westside Hospital, Plantation, USA
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2
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Kioleoglou Z, Georgaki E, Koufopoulos N, Kostek O, Volakakis N, Dimitriadou A, Kokkali S. Gastrointestinal Metastases From Lobular Breast Carcinoma: A Literature Review. Cureus 2024; 16:e65852. [PMID: 39219935 PMCID: PMC11364151 DOI: 10.7759/cureus.65852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
Invasive lobular carcinoma (ILC) represents a rare subtype of breast carcinoma, originating from the lobule. Unlike ductal carcinoma, ILC does not express E-cadherin and thus can metastasize to uncommon sites. We aimed to investigate the clinicopathological characteristics of the rare subgroup of ILC patients with gastrointestinal (GI) metastases. A PubMed search was undertaken using the terms "Lobular Breast Carcinoma" AND "Gastrointestinal Metastasis." We identified 169 cases, with metachronous GI metastatic disease being approximately twice as common as synchronous GI metastases. The median age at initial diagnosis was 56.7 years (24-88). The majority of patients were hormonal receptor-positive and only a small minority was HER2-positive. The appearance of a gastrointestinal lesion was often the mode of revelation of ILC. Differential diagnosis from primary gastrointestinal cancer is sometimes challenging, especially in the case of signet-ring cell carcinoma. The median time from breast cancer diagnosis to GI metastases was 6.5 years (0-33). Most common metastatic sites include the stomach, colon, and rectum, in order of decreasing frequency, whereas metastases were found in every part of the digestive tract. In conclusion, metastases of ILC can arise in the gastrointestinal tract and they should be managed similarly to metastatic breast cancer.
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Affiliation(s)
| | - Eleni Georgaki
- Second Department of Medicine, Medical School, Hippocratio General Hospital of Athens, National and Kapodistrian University of Athens, Athens, GRC
| | - Nektarios Koufopoulos
- Second Department of Pathology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Osman Kostek
- Department of Internal Medicine, Division of Medical Oncology, Sultan 1 Murad State Hospital, Edirne, TUR
| | | | | | - Stefania Kokkali
- Second Department of Medicine, Medical School, Hippocratio General Hospital of Athens, National and Kapodistrian University of Athens, Athens, GRC
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3
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Algethami NE, Althagafi AA, Aloufi RA, Al Thobaiti FA, Abdelaziz HA. Invasive Lobular Carcinoma of the Breast With Rectal Metastasis: A Rare Case Report. Cureus 2022; 14:e23666. [PMID: 35505707 PMCID: PMC9054357 DOI: 10.7759/cureus.23666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/08/2022] Open
Abstract
The rectum is a relatively unusual site for metastasis from invasive lobular carcinoma (ILC) of the breast, and it carries dangers such as perforation and blockage. We reported a case of a 47-year-old female patient complaining of breast ILC for one year. Recently, the patient complained of abdominal distention, mild generalized abdominal pain, and weight loss. The abdominal ultrasound (US) showed moderate ascites without hepatomegaly, and ascitic tapping was positive for malignant cells. Lower colonoscopy showed a congested mass of 8 cm, and anal verge biopsy showed colonic mucosa laminal propria infiltrated with atypical cells and adenocarcinoma metastatic from the breast. In a patient with breast cancer, particularly ILC, who has developed new gastrointestinal tract (GIT) symptoms, there is significantly a high chance of rectal metastatic illness. Early detection is critical for successful treatment.
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4
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Bolzacchini E, Nigro O, Inversini D, Giordano M, Maconi G. Intestinal metastasis from breast cancer: Presentation, treatment and survival from a systematic literature review. World J Clin Oncol 2021; 12:382-392. [PMID: 34131569 PMCID: PMC8173325 DOI: 10.5306/wjco.v12.i5.382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/23/2021] [Accepted: 04/14/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intestinal metastases from breast cancer (BC) arerare; available data depend mainly on case reports and case series.
AIM To conduct a review of the literature regarding presentation, diagnosis, treatment and survival of patients with intestinal metastasis from BC.
METHODS We identified all articles that described patients with intestinal metastasis (from duodenum to anum) from BC using MEDLINE (1975 to 2020) and EMBASE (1975 to 2020) electronic databases.
RESULTS We found 96 cases of intestinal metastasis of BC. Metastasization involved large bowel (cecum, colon, sigmoid, rectum) (51%), small bowel (duodenum, jejunum, ileum) (49%), and anum (< 1%). Median age of patients was 61-years. The most frequent histology was infiltrating lobular carcinoma followed by infiltrating ductal carcinoma. In more than half of patients, the diagnosis was made after the diagnosis of BC (median: 7.2 years) and in many cases of emergency, for bowel obstruction, bleeding or perforation. Diagnosis was achieved through endoscopy, radiological examination or both. In most of the cases, patients underwent surgery with or without systemic therapies. Survival of patients included in this review was available in less than 50% of patients and showed an overall median of 12 mo since diagnosis of the intestinal metastasis.
CONCLUSION Although, intestinal metastases of BC are considered a rare condition, clinicians should consider the possibility of intestinal involvement in case of abdominal symptoms even in acute setting and many years after the diagnosis of BC, especially in patients with a histology of lobular carcinoma.
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Affiliation(s)
- Elena Bolzacchini
- Department of Oncology, Ospedale Sant' Anna, ASST Lariana, Como 22100, Italy, Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy
| | - Olga Nigro
- Department of Oncology, Ospedale di Circolo ASST-Sette Laghi, Varese 21100, Italy
| | - Davide Inversini
- Department of General Surgery, Ospedale Sant' Antonio Abate, ASST Lariana, Cantu' 22100, Italy
| | - Monica Giordano
- Department of Oncology, Ospedale Sant' Anna, ASST Lariana, Como 22100, Italy
| | - Giovanni Maconi
- Department of Biomedical and Clinical Sciences, Gastroenterology Unit, "Luigi Sacco" University Hospital, Milano 20157, Italy
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Liu M, Zhang L, Guo L, Lv J, Shi W, Liu B. Intestinal metastasis from breast invasive ductal carcinoma after a long latency: case report and literature review. Onco Targets Ther 2018; 11:8599-8603. [PMID: 30584319 PMCID: PMC6284526 DOI: 10.2147/ott.s180949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Intestinal metastasis from breast cancer (BC) is rarely encountered in clinical practice. Nonspecific symptoms and long latency result in misdiagnosis as a primary intestinal tumor. Therefore, increased awareness of bowel metastasis secondary to BC and a thorough understanding of the clinical and molecular features, and intervention of bowel metastasis are fundamental to avoid the delay of correct diagnosis and management. Herein, we documented a BC patient who experienced progressive bellyache and vomiting 16 years after simplified radical mastectomy. Abdominal CT scan revealed localized thickening of the small intestine wall and lumen narrowing, initially diagnosed as a primary intestinal tumor. The subsequent operation resolved the intestinal obstruction and confirmed the diagnosis of intestinal involvement of BC. Radical local treatment followed by systemic intervention contributed to a better outcome. Our case indicates that intestinal metastasis should be included in the diagnostic checklist in patients presented with any intestinal symptom even with a remote history of BC. Our case is of great value in its rarity and calls for the awareness of clinicians for this special entity to guarantee the accurate and prompt diagnosis and treatment, and optimize the patient’s prognosis.
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Affiliation(s)
- Min Liu
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun 130021, China,
| | - Lei Zhang
- Department of Radiology, The First Hospital, Jilin University, Changchun 130021, China
| | - Liang Guo
- Department of Pathology, The First Hospital, Jilin University, Changchun 130021, China
| | - Jincai Lv
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun 130021, China,
| | - Weiyan Shi
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun 130021, China,
| | - Bailong Liu
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun 130021, China,
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Ruymbeke H, Harlet L, Stragier B, Steenkiste E, Ryckx M, Marolleau F. Anorectal metastasis from breast carcinoma: a case report and review of the literature. BMC Res Notes 2018; 11:268. [PMID: 29720242 PMCID: PMC5932764 DOI: 10.1186/s13104-018-3356-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/18/2018] [Indexed: 01/13/2023] Open
Abstract
Background Gastrointestinal metastasis from primary breast carcinoma is uncommon, anorectal involvement is extremely rare. Case presentation We present the case of a 65-year old woman who underwent treatment for an infiltrative lobular carcinoma of the left breast with bone metastases and who developed metastasis of the rectum and anal canal 4 years later. Conclusions A patient with a history of breast cancer, especially lobular carcinoma, presenting with anorectal symptoms, should raise the suspicion of metastatic disease.
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Affiliation(s)
- Hannes Ruymbeke
- Resident in Internal Medicine, Ghent University, Ghent, Belgium. .,, Breedstraat 265, 9100, Sint-Niklaas, Belgium.
| | - Luc Harlet
- Department of Gastroenterology, AZ Delta, Menen, Roeselare, Belgium
| | - Barbara Stragier
- Department of Medical Oncology, AZ Delta, Menen, Roeselare, Belgium
| | - Edwin Steenkiste
- Department of Anatomopathology, AZ Delta, Menen, Roeselare, Belgium
| | - Merijn Ryckx
- Resident in Internal Medicine, Ghent University, Ghent, Belgium
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Falco G, Mele S, Zizzo M, Di Grezia G, Cecinato P, Besutti G, Coiro S, Gatta G, Vacondio R, Ferrari G. Colonic metastasis from breast carcinoma detection by CESM and PET/CT: A case report. Medicine (Baltimore) 2018; 97:e10888. [PMID: 29794798 PMCID: PMC6392653 DOI: 10.1097/md.0000000000010888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Metastatic spread in invasive lobular carcinoma (ILC) of breast mainly occurs in bones, gynecological organs, peritoneum, retroperitoneum, and gastrointestinal (GI) tract. Metastases to the GI tract may arise many years after initial diagnosis and can affect the tract from the tongue to the anus, stomach being the most commonly involved site. Clinical presentations are predominantly nonspecific, and rarely asymptomatic. CEA, CA 15-3, and CA 19-9 may be informative for symptomatic patients who have had a previous history of breast cancer. CASE PRESENTATION We introduce the case of asymptomatic colonic metastasis from breast carcinoma in a 67-year-old woman followed-up for Luminal A ILC. Diagnosis was performed through positron emission tomography/computed tomography (PET/CT) scan and contrast-enhancement spectral mammography (CESM), steering endoscopist to spot the involved intestinal tract and in ruling out further dissemination in the breast parenchyma. CONCLUSION In colonic metastases, tumor markers might not be totally reliable. In asymptomatic cases, clinical conditions might be underappreciated, missing local or distant recurrence. CT and PET/CT scan might be useful in diagnosing small volume diseases, and steering endoscopist toward GI metastasis originating from the breast. CESM represents a tolerable and feasible tool that rules out multicentricity and multifocality of breast localization. Moreover, particular patients could tolerate it better than magnetic resonance imaging (MRI).
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Affiliation(s)
- Giuseppe Falco
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
| | - Simone Mele
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
| | - Maurizio Zizzo
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena
| | - Graziella Di Grezia
- Radiology Department, Criscuoli Hospital, Sant’ Angelo dei Lombardi, Avellino
| | - Paolo Cecinato
- Department of Oncology and Advanced Technologies, Gastroenterology-Digestive Endoscopy Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
| | - Giulia Besutti
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena
- Department of Imaging and Medicine of Laboratory, Radiology Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
| | - Saverio Coiro
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
| | - Gianluca Gatta
- Radiology Department, “Luigi Vanvitelli” University of Campania, Naples, Italy
| | - Rita Vacondio
- Department of Imaging and Medicine of Laboratory, Radiology Unit, IRCCS Santa Maria Nuova Hospital, Reggio Emilia
| | - Guglielmo Ferrari
- Department of Oncology and Advanced Technologies, Breast Surgery Unit, IRCSS Santa Maria Nuova Hospital, Reggio Emilia
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8
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Roy AC, Wattchow D, Astill D, Singh S, Pendlebury S, Gormly K, Segelov E. Uncommon Anal Neoplasms. Surg Oncol Clin N Am 2017; 26:143-161. [DOI: 10.1016/j.soc.2016.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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9
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Black M, Hakam A, Harris C, Jiang K. Metastatic breast carcinoma uncovered in an otherwise unremarkable “random colon biopsy”. HUMAN PATHOLOGY: CASE REPORTS 2016. [DOI: 10.1016/j.ehpc.2015.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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10
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Rengifo C, Titi S, Walls J. Anal metastasis as the sentinel and isolated presentation of invasive ductal breast carcinoma. Ann R Coll Surg Engl 2016; 98:e68-70. [PMID: 27087339 DOI: 10.1308/rcsann.2016.0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Breast cancer currently affects 1 in 8 women in the UK during their lifetime. Common sites for breast cancer metastasis include the axillary lymph nodes, bones, lung, liver, brain, soft tissue and adrenal glands. There is well documented evidence detailing breast metastasis to the gastrointestinal tract but anal metastasis is exceptionally rare. We present the case of a 78-year-old woman with an anal metastasis as the sentinel and isolated presentation of an invasive ductal breast carcinoma. As advances in the treatment of breast cancer improve, and with an ageing and expanding population, there will be an increasing number of cancer survivors, and more of these unusual presentations may be encountered in the future.
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Affiliation(s)
- C Rengifo
- Pennine Acute Hospitals NHS Trust , UK
| | - S Titi
- Pennine Acute Hospitals NHS Trust , UK
| | - J Walls
- Pennine Acute Hospitals NHS Trust , UK
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11
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Unexpected diagnosis of both adenocarcinoma of the colon and metastatic lobular carcinoma of the breast in the gastrointestinal tract. Case Rep Pathol 2013; 2013:153180. [PMID: 23984147 PMCID: PMC3741921 DOI: 10.1155/2013/153180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 06/30/2013] [Indexed: 12/26/2022] Open
Abstract
Breast cancer rarely metastasises to the gastrointestinal tract. Lobular carcinoma more commonly metastasises to the uterus and appendages, peritoneum, and gastrointestinal tract than other types of breast cancer, while ductal carcinoma has a propensity to metastasise to the lungs, liver, and brain. We describe the case of a patient with no known history of breast cancer, whose primary presentation of lobular breast cancer was with malignant small intestinal and colonic strictures, with coexisting previously undiagnosed adenocarcinoma of the colon.
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12
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Metastatic breast cancer to the gastrointestinal tract: report of five cases and review of the literature. Int J Breast Cancer 2012; 2012:439023. [PMID: 23091732 PMCID: PMC3471430 DOI: 10.1155/2012/439023] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 09/04/2012] [Indexed: 12/17/2022] Open
Abstract
Luminal gastrointestinal (GI) metastases from breast cancer are rare, reports are fragmentary and poor. The purposes of this study are to assess the gastrointestinal involvement from breast cancer in a retrospective study at a single institution and reviewing the related literature. Between January 2007 and December 2011 a total of 980 patients with breast cancer were treated at our institution, patients' records and report database were analysed. Institutional Review Board approval was obtained for this study. A search of the literature using PubMed, CancerLit, Embase, was performed. Selected for the present review were papers published in English before June 2012. Five of 980 patients (0.5%) showed gastrointestinal metastases from breast cancer, 3 patients had gastric involvement, 1 jejunum, and 1 rectum. Reviewing the literature, 206 patients affected by gastrointestinal metastasis from breast cancer were identified: the most frequent site of metastasis was the stomach (60%). The majority of the patients underwent chemotherapy and endocrine therapy, someone surgery and radiotherapy. GI metastases from breast cancer are rare, but possible, and a very late recurrence can also occur. Cyto-histological diagnosis is mandatory, to differentiate GI metastases from breast cancer to other diseases and to allow an adequate treatment.
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Bochicchio A, Tartarone A, Ignomirelli O, Latorre G, Cangiano R, Gallucci G, Coccaro M, Feudale E, Aieta M. Anal metastasis from breast cancer: a case report and review of the literature. Future Oncol 2012; 8:333-6. [PMID: 22409468 DOI: 10.2217/fon.12.9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Breast cancer usually metastasizes towards the lymph nodes, lung, bone, liver or brain; metastatic gastrointestinal involvement is rare and anal metastases are extremely rare. Necroscopic studies report a 6-18% incidence of extra-hepatic gastrointestinal metastases, and the most frequent sites of the GI tract involved are the stomach and the small intestine. We report a case with anal metastasis from breast cancer and a review of the associated literature.
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Affiliation(s)
- Annamaria Bochicchio
- Department of Onco-Hematology, Centro di Riferimento Oncologico della Basilicata IRCCS, Via Padre Pio 1, 85028 Rionero in Vulture (PZ), Italy
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14
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Zhao R, Li Y, Yu X, Yang W, Guo X. Duodenal metastasis from recurrent invasive lobular carcinoma of breast: a case report and literature review. Int J Clin Oncol 2011; 17:160-4. [PMID: 21638025 DOI: 10.1007/s10147-011-0258-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 05/16/2011] [Indexed: 12/21/2022]
Abstract
We present a rare case of duodenal metastasis from invasive breast lobular carcinoma, which first presented clinically as elevated serum tumor marker levels, followed by jaundice but with no other clinical evidence of recurrence and metastasis. A 53-year-old woman underwent modified radical mastectomy of the left breast (pT2 N3 M0 stage III c) followed by postoperative chemo-radiotherapy and hormonal therapy. After about 3 years, the patient presented with elevated serum tumor marker levels and mild jaundice. She was subsequently admitted to the hospital for nausea and severe vomiting. A duodenoscopy revealed the thickening of duodenal papilla on the lateral wall and stenosis. A duodenal tissue biopsy revealed poorly differentiated adenocarcinoma, and immunohistochemical staining suggested that the carcinoma was of breast origin. The patient received further radiation and chemotherapy. Although duodenal metastases of breast cancer are rare, physicans should be alert and vigilant when a patient with a history of breast cancer presents with new gastrointestinal symptoms.
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Affiliation(s)
- Ruping Zhao
- Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai, 200032, China
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